Simultaneous versus staged-bilateral THA using a piriformis-preserving minimally-invasive posterolateral approach.

Abstract

There is still debate regarding the rationale for 1-stage bilateral total hip arthroplasty (THA). We aimed to compare re-admissions, adverse events, and total length of stay in patients with simultaneous bilateral versus staged THA. We identified 166 patients who underwent bilateral THA. They were matched based on sex, preoperative haemoglobin and the time interval between surgeries. A cohort of 84 simultaneous bilateral THA was compared to 82 staged bilateral THA. Median follow-up was 64.5 months. Logistic regression showed that type of surgery was not associated with risk of complication. No significant differences were observed between simultaneous and staged bilateral THA in terms of short-term or long-term adverse events (OR 0.76; 95% CI, 0.31-1.85; <i>p</i> = 0.558; and OR 1.32; 95% CI, 0.27-6.42; <i>p</i> = 0.728, respectively). Similarly, surgical strategy was not associated with risk of re-admission (<i>p</i> = 0.606). Staged bilateral THA was significantly associated with total length of stay (LOS), with an average increase of 2.00 days compared to simultaneous procedures (Coefficient 2.00; 95% CI, 1.36-2.64; <i>p</i> < 0.001). In this matched-cohort study, single-anaesthetic bilateral THA was not associated with an increased risk of adverse events and re-admissions, suggesting it is a safe procedure, while decreasing operating room time, length of stay and anaesthesia-related risks.